Provider Demographics
NPI:1538619473
Name:SHARP, SKYLER TYNE (FNP)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:TYNE
Last Name:SHARP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5173 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MT JACKSON
Mailing Address - State:VA
Mailing Address - Zip Code:22842
Mailing Address - Country:US
Mailing Address - Phone:276-237-1880
Mailing Address - Fax:
Practice Address - Street 1:759 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1154
Practice Address - Country:US
Practice Address - Phone:540-459-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017143217363L00000X
VA0024173985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner